The Multi-Ethnic Study of Atherosclerosis (MESA) is a multicenter, cohort study in which a population-based sample of 6,814 Caucasian, Hispanic, African-American and Asian-American men and women aged 45-84 with subclinical cardiovascular disease are followed for 10 years to identify factors predictive of progression to overt cardiovascular disease. The MESA study is sponsored by NHLBI and is funded under contract. Dr. Cotch is a collaborator in the MESA-EYE component (refraction and fundus photography). Part of the second MESA visit and beginning in September 2002, the aims of the ocular component are to document the presence and severity of retinal microvascular changes (as interpreted from digital retinal photos) indicative of macular degeneration and diabetic retinopathy, as well as to describe their interrelationships with cross-sectional and longitudinal measures of microvascular and macrovascular systemic disease. The visual acuity/objective refraction component will allow us to estimate visual impairment by sex and ethnicity, determine the degree to which visual impairment could be reduced with better refractive correction, and correlate visual findings with retinal pathology. During this fiscal year, quality control procedures were developed and implemented. Data management activites are underway. As of August 2003, 4736 MESA participants completed the ocular component. The projected completion of the second MESA visit for all members of the MESA cohort is scheduled to occur next fiscal year. Data are projected to be available for analytic purposes a few months thereafter.